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Beyond the Blues: When Sadness Becomes Depression Welcome & overview of today s call Introduction & Message from: Leah Eskenazi, Family Caregiver Alliance Thank-you to Partner Organizations Caregiver welcome Elizabeth Dole Foundation Fellow, Debbie Sprague (California) Guest Speakers Christina Irving Leah Eskenazi Online Q & A VA Caregiver Support Program Thank-you and next steps November is National Family Caregivers Month!

Partners Atlas Research Caregiver Action Network Easter Seals Dixon Center Elizabeth Dole Foundation Family Caregiver Alliance (today s host organization!) National Alliance for Caregiving Rosalynn Carter Institute for Caregiving USO

Family Caregiver Alliance is mission driven to improve the quality of life for caregivers, caregiving families and loved ones receiving care through education, support services, research and advocacy. FCA s National Center on Caregiving, works to advance the development of high-quality, cost effective programs and policies for caregivers in every state in the country. Visit the Family Care Navigator on our website to find locate support services in your community. FCA s Bay Area Caregiver Resource Center, serving the San Francisco Bay Area, works closely with families caring for ill or frail loved ones. Our community based services, education programs and fact sheets offer families direct support, vital information, and effective tools to manage the complex and demanding tasks of caregiving. Find Us Online: https://www.caregiver.org Social Media: Facebook (Family Caregiver Alliance) Twitter ( @CaregiverAlly ) YouTube ( CAREGIVERdotORG ) Address: 785 Market Street, Suite 750, San Francisco, CA 94103 Call Us : (800) 445-8106 or (415) 434-3388

Debbie Sprague (California): After eighteen months of duty in Vietnam, my husband Randy returned home safely. 30 years later the Vietnam War changed our life. The events that followed took a toll on me as well. I totally lost myself in a dark cloud of OVERWHELM and DEPRESSION

I learned that I WAS NOT ALONE With training and education I was able to begin caring for my own needs. This has enabled me to provide better care for the loved one s who depend on me. You can contact me at HiddenHeroes@elizabethdolefoundation.org or 202-266-7928

Click to edit Master title style Click to edit Master subtitle style Beyond the Blues: When Sadness Becomes Depression Leah Eskenazi, MSW Christina Irving, LCSW Family Caregiver Alliance November 13, 2014

Depression and Military Caregivers What is depression? How to recognize depression? Risk factors for military caregivers Strategies to help

Depression in Military Caregivers Caregivers: 5.5 million est. military caregivers in USA 1.1 million caring for post 9/11 service member At Risk for Depression: 38% post 9/11 caregivers 19% pre 9/11 caregivers 20% non-military caregivers Hidden Heroes: America s Military Caregivers, RAND Corporation

Risk Factors Family history of depression Financial strain Caregiver s health problems Isolation/loneliness Employment problems Juggling caregiving role and parenting young children Relationship problems Severity of care recipient s condition Grief and loss New baby

True or False? Only emotionally troubled people get depressed. 1 in 10 U.S. adults are affected by depression. People who say they are depressed are weak and just need to pull themselves together. Depression is a diagnosable medical condition. www.mentalhealthscreening.org

What does depression look like? Mary is a 28 year old wife of an Army Veteran. He suffers from back problems and a Traumatic Brain Injury from an IED. John s daughter was in the Army Reserve and now suffers from PTSD following a sexual assault. Yvonne, age 75, cares for her husband who is a Vietnam Veteran with dementia and physical health problems. 2011 Family Caregiver Alliance

Signs of Depression: Physical Trouble sleeping or sleeping too much Loss of energy or feeling tired all the time Loss of appetite or eating too much Headaches, digestive problems, and other aches and pains that don t go away with treatment Increased use of alcohol or substance abuse

Signs of Depression: Mental & Emotional Feelings of hopelessness, helplessness, or guilt Persistent feelings of sadness Loss of pleasure or interest in things you used to enjoy Feeling restless Feeling irritable Problems with concentration and decision-making Thoughts of suicide or self-harm Suicide hotline: 1-800-273-TALK

How Do I Know? My HealtheVet Depression Screening University of Michigan Depression Center www.depressiontoolkit.org Digital Monitoring Tools: T2 Mood Tracker

60-70% percent of military caregivers who meet the criteria for clinical depression don t get treatment

Seek Treatment for Depression! See your doctor Medications Psychotherapy or counseling The earlier treatment begins, the more effective it can be.

Therapy and Counseling Finding a therapist What s in a name? Cognitive Behavioral Therapy (CBT) Interpersonal Therapy The therapy session 50 minutes History Frequency

Barriers to Treating Depression Stigma Time Feeling hopeless Not knowing where to start Less Focus on Caregiver Caregiver Support Line 1-855-260-3274

Keys for Treating Depression Seek support as soon as possible Set realistic goals Break up large tasks and set priorities Postpone important decisions Expect your mood to improve gradually Avoid substance misuse

Strategies to Improve Your Mood Exercise Yoga & Breathing Exercises Soothing Sensory Touch Sleep Mindfulness Meditation Journaling Self Talk Social Support

Exercise To Start: Frequency - 3x a week Intensity - 15 to 20 minutes Call a friend today to take a walk for: A Better Mood Reduced Anxiety, and Improved Physical Health

Yoga & Breathing

Soothing Sensory Touch

Sleep Keep a regular sleep/wake schedule Get into bright light upon waking in the a.m. Avoid afternoon naps if you have nighttime insomnia Limit caffeine and alcohol

Journaling Clarify Your Thoughts, Feelings & Moods Track What Makes you Feel Better Release the Intensity of Emotions Sort out Problems

Journaling Prompts Today I am grateful for. Things that I love: I feel stressed today because. Things that keep my spirits up.

Self-Talk Embrace self talk to encourage yourself as you go through your day. Three steps to Help Gain Control of Your Feelings: 1. Stop and Identify Current Thoughts 2. Challenge and Replace Non-Helpful Thoughts 3. Pay Attention to How You Feel (Source: David Coon - PhD, Professor, and Associate Vice Provost, Health Solutions, at Arizona State University.)

Self-Talk Check Situation (example) Negative Self- Talk Resulting Feelings Challenge & Replace with Positive Positive Feelings My husband refuses to socialize with our friends anymore. We used to love to go out dancing and for drinks. Now he just drinks alone at home and is angry with me and the kids. No one wants to be friends with us anymore. Everyone will think I am a bad wife and mother - he sure does. No one likes us anymore. No one cares about me. Embarrassed Guilty Isolated Unappreciated Anxious Sad I told my mom what I was feeling. She said I am a good wife & parent. I texted a caregiver to meet for coffee. She said yes! My husband can t care for me like he used to. We need to figure out this new normal. A complement helps me feel more confident I am happy to have a new friend. My husband is ill not me. I ll check with the CSC for help.

Self-Talk Check Situation (example) Negative Self-Talk Resulting Feelings Challenge & Replace with Positive Positive Feelings My neighbors and children will see my husband in the same clothes every day. Everyone will think I don t care about my husband. Everyone will thing he is dirty and his clothes are dirty. My children will think I have given up. Embarrassed Guilty Sad Angry I told my neighbor. They asked for info about dementia and said they see how much I do for Ed. My children say, we hope our spouses love us as much as you love papa. I know that he is clean. Less trapped and less guilty. Happier More relaxed. Less embarrassed with those who know me.

Social Support Social Activities Asking for Help Support Groups Counseling

True or False Talking about depression will make my friends not want to spend time with me.

Reach Out when you're tackling something that's painful and troubling and is causing you such desperate grief that you think life's not worth living, you need to reach out reach out before then, actually. Reach out to people whom you trust, people who will reach back and offer you some solace and some guidance. Because it doesn't happen alone. And if I had been just left on my own, well, I wouldn't be here. ~ Tim Gunn, fashion guru, Project Runway host

It s hard to be a friend to someone who s depressed, but it is one of the kindest, noblest, and best things you will ever do. ~ Stephen Fry (English comedian & actor)

To help your friend or relative: Offer emotional support Listen carefully Never dismiss feelings Initiate activities Give help to get to appointments Never ignore comments about suicide Things you can say to someone with depression: http://www.huffingtonpost.com/2014/09/11/supportive-depression-what-to-say_n_5760916.html

Start Here Call the Caregiver Support Line: 1-855-260-3274 Take a Walk, Stretch, Breathe What are you Grateful for? Write in a Journal Talk to Someone You Trust About How You Feel

Get on the Safe Path There's nothing, repeat, nothing to be ashamed of when you're going through a depression. If you get help, the chances of your licking it are really good. But, you have to get yourself onto a safe path. ~ Mike Wallace (American Journalist, 60 Minutes)

Resources to Get you Started: Family Caregiver Alliance fact sheet https://caregiver.org/depression-and-caregiving Make The Connection (sponsored by the VA) http://maketheconnection.net/conditions/depression Give an Hour http://www.giveanhour.org

VA Caregiver Support Program www.caregiver.va.gov (855) 260-3274

Military & Veteran Caregivers Webinar Series Stay tuned next webinar scheduled for January 8 th (topic of intimacy) Handouts, recording, & transcript to be posted to www.easterseals.com/carewebinar Contact: militarycaregiver@easterseals.com with any questions Will keep you apprised of future webinars and new partner resources